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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> IPhoenix,Arizona 85003 Well No MW-5B <br /> 642-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Site ID --.q-Haul #709-50 0 Other <br /> Protect No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By _ Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date Purge Method <br /> Casing Diameter(D)in Inches KBaiier-Type 6'K_it 1' -17vc-- <br /> I E 2-inch ❑ 4-inch ❑ 6-inch ❑ Other • ubl'M e ❑ Submersible Whale _ <br /> Total Depth of Casing(TD in feet BTOC) ❑ Other <br /> Water Level Depth (WL in feet BTOC) Pump Intake Setting <br /> Number of Weil Volumes(#Vols)to be Purged ❑ Near Bottom ❑ Near Top ❑ Other <br /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(STOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> r2 to 72 <br /> ` D&el' WL(reels X 2 X 3 X 0 0409 = Y o <br /> ` } ) D(inches) #Vols gallons <br /> Calculated Purge Volume <br /> Pump Time Purge RateActual Purge Volume <br /> Start it>, Stop//3o Time Elapsed Initial gpm Yl S_ gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg/L) Cond 1 Cond 2 Salinity Temp pH Notes <br /> (umhos/cm) (umhos/cm) r <br /> Zo / <br /> /i d-7 7- 15' S o 7b' - -- 3 <br /> 4-6, - 4,5' 7 <br /> Observations During Purging(well Condition Turbidity Color Odor,etc <br /> AA4,- 4Q-C— <br /> 4, <br /> Purge Water Storage/Disposal [] Drum(s),Number Storm Sewer ❑ Sanitary Sewer <br /> Other/Comments Purge water contained in on-site 1 000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By Isampling Date I t/rjjlj3 ISampling Time I 747f <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type 3 b ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution W7 Sample Series <br /> _ Sample No Containers,Vol # Analysis — PreservativeT- Lab -- Comments <br /> Other Notes <br />